Pharmacist Interview Questions

Introduce yourself
My name is ………., I have been a pharmacist for over 7 years. I got my license in 2014. I started my first career as a pharmacist manager. In ………. I applied to the PharmD program at the University of Toronto, and I received my PharmD degree in March …… during this program, I completed many direct and indirect patient care rotations. One of them was done in Ontario shores Center for Mental Health Sciences. The other one was done in Bluewater Health Hospital in Sarnia in the cardiology department. In addition to the clinical rotations, I also completed 16 pharmacotherapy courses including Cardiology, Oncology, Primary care, Nephrology, and infectious diseases.
During my clinical rotations, I learned how to: 

• Address reason for admission (or chief complaint)
• Review BPMH/Medication Reconciliation using at least 2 sources of information such as med list from community pharmacy, MAR from long-term care facilities, DPV (online), or e-health.
• Assess medication profile, looking for any potential or actual DTPs
• Assess additional medical information (i.e. lab work, imaging, reports written by doctors and other health care providers.)
• Estimate the renal function using Cock-croft Gault equation and make any dose adjustment if required.
• Make and prioritize recommendations based on acuity
• Create a follow-up plan, including monitoring of effectiveness and safety within the specific time frame.
• Considering deprescribing of unnecessary medication.
• PDiF (pharmacist discharge facilitator), so I was responsible for Counseling the patient on the new medications.
• Attending the patients’ rounds with doctors and nurses.
• Have more opportunities to interact closely with the prescribers and, therefore, to promote the rational prescribing and use of drugs.

Besides my clinical experience, I have 7 years of experience as a community and manager pharmacist in Canada.

What do you know about Mount Sinai Hospital?
Sinai Health includes Mount Sinai Hospital, Hennick Bridgepoint Hospital, the Research Institute, and the Circle of Care.
Mount Sinai Hospital, part of Sinai Health, is an academic health science center, affiliated with the University of Toronto.

Classification:

• Group A Hospitals: Teaching general hospital
• Group M Hospitals — Computerized Axial Tomography (CTs)
• Group N Hospitals — Magnetic Resonance Imaging (MRI)
• Group Q Hospitals — In Vitro Fertilization 

Values: humanity, service, inclusivity, and discovery
Services: family medicine, psychiatric conditions, cardiovascular, and cancer care

Mount Sinai Hospital, located in Toronto, Ontario, Canada, is an academic health science center affiliated with the University of Toronto. Here are some key details about this renowned institution:

1. Comprehensive Care: Mount Sinai Hospital provides patient care, teaching, and research services. Patients from across the province and the entire country come here to access specialized and inclusive care focused on patients’ humanity¹.

2. Affiliation: It is part of Sinai Health, which was formed through the voluntary amalgamation of Mount Sinai Hospital and Hennick Bridgepoint Hospital on January 22, 2015²³.

3. Legacy of Care: In 2024, Mount Sinai Hospital celebrates its 100th anniversary, reflecting its long-standing commitment to healthcare excellence².

4. Redevelopment: The hospital is currently undergoing its largest and most ambitious redevelopment in history, aiming to enhance facilities and services for patients².

5. Specialties and Research: Mount Sinai Hospital specializes in various areas, including breast health, emergency medicine, and urology. It houses the Lunenfeld-Tanenbaum Research Institute, contributing to cutting-edge research and advancements in healthcare

What do you know about Christopher Sharp Cancer Centre?
The Christopher Sharp Cancer Centre is a Canadian Leader in Cancer Care and the largest Non-regional specialized cancer program in Ontario. We treat cancers that can be challenging, fast spreading and complex and are at the forefront in innovative surgeries, treatments and research. The Out-Patient Clinic provides care to patients with Breast, Colorectal, Gastrointestinal, Lung, Sarcoma, and Hematology cancers. The In-Patient program is focused on providing care to patients with Sarcoma.

What do you know about Christopher Sharp?

The Christopher Sharp Cancer Centre at Mount Sinai Hospital is a significant institution dedicated to cancer care and research. Let me share some details about it:

• Christopher Sharp was born in 1960, the third son of Isadore and Rosalie Sharp. He grew into a charming and handsome young man, known for his natural hosting abilities and warm, personable style. Tragically, Chris was diagnosed with melanoma at just 17, but due to a previous misdiagnosis, it was detected late. Despite his illness, he continued to live life and have fun.

• Chris’s parents, Isadore and Rosalie, had previously been involved in fundraising for cancer charities. Inspired by their son’s legacy, they founded the Terry Fox Run, which has become one of Canada’s largest and most successful fundraising events.

• In 2013, the Sharps donated a generous sum of $15 million to create the Chris Hugh Sharp Cancer Centre at Mount Sinai Hospital, which is part of Sinai Health. Their gift embodies Chris’s memory and demonstrates their commitment to helping other patients and their families living with cancer¹.

The Christopher Sharp Cancer Centre focuses on screening and diagnosis, cancer treatments, and research and learning. It stands as a testament to the impact that individuals and families can make in the fight against cancer.

• He was born in 1960 and died in 1978
• He was diagnosed with melanoma at the age of 17
• Chris’s death inspired the Sharp family to found the Terry Fox Run and they donated $15 million to create the Chris Sharp Cancer Centre at Mount Sinai Hospital

What do you know about cancer care at Mount Sinai Hospital?
Cancer care at Sinai Health focuses on individuals, their families, and caregivers. Mount Saini provides individualized and comprehensive treatments that include surgery chemotherapy and/or systemic therapy administered by the care team. The care team includes doctors, nurses, pharmacists, a drug access navigator, a dietitian, genetic counselors, clinical trial researchers, psychosocial oncology experts from social work and psychiatry, and integrated palliative care specialists. Patients can get cancer care from Christopher Sharp Center or Marvelle Koffler Breast Centre

Can you tell me about a time when things did not go according to plan? How did you react?
I was hired to be a manager for a pharmacy from scratch, the owner asked for specific targets of Rx number and also the net profit of the pharmacy. At that time, there was only one technician to help me out, but she did not have enough experience, so I had to do everything myself which put me under great pressure so I couldn’t achieve the target in the first 6 months. I used the STAR method for analysis which stands for structure, task, action, and result. I asked the owner to hire one more experienced technician, and within the next 6 months the pharmacy started to achieve the target.

What are your strengths and weaknesses? 
My strengths are:

• I am very fast learner: after 2 weeks of training at CGMH, I was able to work independently
• I am a goal oriented person, I know very well what should I do and when it should be done
• I am very accurate, paying attention to the details.

My weaknesses:

• Sometimes, I do not know how to balance between and my personal and professional life
• It is not easy to delegate somebody to do something until I am sure they have enough training to do it perfectly

Do you have any questions?
Yes, Can you tell me more about

• What does my schedule look like?
• Are there any night shifts, extra hours, or on-calls?
• Do you pay the fees for any continuing education programs?
• Are there opportunities for training and career progression?

What to Say When You Don’t Know the Answer?

• What exactly do you mean by that? Can you please ask the question differently?
• I don’t have enough experience with that but I have experience with a similar situation
• I do not know exactly the answer, but I will get back to it once I finished my interview and I will email you the answer.

How to manage conflict with a colleague?

• Talk with the other person. …
• Focus on behavior and events, not on personalities. …
• Listen carefully. …
• Identify points of agreement and disagreement. …
• Prioritize the areas of conflict. …
• Develop a plan to work on each conflict. …
• Follow through on your plan. …
• Build on your success.

What are the challenges for clinical pharmacists?

• Acceptance of our clinical services among other healthcare providers
• Answering the questions directed from other health care providers to the pharmacy department accurately on time using high-quality sources of information.

Why do you want to work as a hospital pharmacist?
I’m looking for a new opportunity that gives me the ability to apply the clinical knowledge I have learned from the PharmD program into real practice. I also enjoy being in the hospital environment and being part of the wider multidisciplinary team, working together to help care for patients, exchanging experiences and knowledge, and building on the experiences shared with other healthcare providers.

What do you dislike about your career in pharmacy?

• We do not have prescriptive authority yet in Ontario
• Some prescribers are not open to suggestions or interventions from pharmacists. In other words, they are not familiar with the recent changes such as the expanded scope of practice.

Why do you want to work for us?
Because you have many offers and benefits, such as

• Your hospital provides cancer care, and I am interested in training and have more experience in this field.
• I plan to continue my education and be board-certified oncology pharmacist, so I want to work in a facility where I can progress to higher levels of training and responsibility.
• I want to work in a large hospital environment because it provides opportunities for me to expand my knowledge through training and by working alongside experts.
• I am looking for a stable, long-term position, and this hospital is known for its strong, collaborative teams and career satisfaction.

Which continuing education program did you complete last year? 

• PharmD Program
• COVID-19 Vaccine Curriculum
• Non-direct patient care (qualitative analysis of clinical data) U of T
• Oncology Pharmacy

Tell me about a big achievement you made.

• I have completed the PharmD program
• I helped around 30 patients quit smoking
• I have completed many continuing education programs

What are the differences between community and hospital pharmacists?
Community pharmacists focus on filling prescriptions written by doctors. While community pharmacists occasionally make substitutions based on the medicines currently available, most focus more on everyday treatments and problems. Hospital pharmacists usually work with more challenging and complex cases, especially those requiring patients to remain in the hospital for observation. Aside from the difficulty of the cases, hospital pharmacists frequently consult other staff and help make decisions about patient care and treatment options. This is especially true when evaluating treatments for potential chemical conflicts, using investigational drugs, or creating new compounds. The challenge of pharmacy work in a hospital environment means that most employers prefer applicants who already have experience working in a hospital pharmacy.

What are the differences between the scope of practice of pharmacists and pharmacy technicians?   

Pharmacist

Pharmacy Technician

Be accountable and responsible for the therapeutic/clinical appropriateness of all new and refill prescriptions and all therapeutic consultations. Initiate medication for smoking cessation or in emergency use. Renewal, adaptation, or deprescribing. Injecting vaccines. Recommending schedule II and schedule III medications for minor ailments. Counseling patients about medications. Pharmaceutical Opinion Medication review for regular or diabetic patients.

The scope of practice of a Pharmacist Technician varies for each jurisdiction across Canada. In Ontario: Are accountable and responsible for the technical aspects of both new and refill prescriptions, (i.e. the correct patient, drug dosage form/route, dose, doctor). Pharmacy technicians are also permitted to accept verbal prescriptions (except for narcotics, controlled drugs, benzodiazepines, and targeted substances) and provide prescription transfers. Compound drugs according to a Master Formula or Compounding Protocol Provide instructions on how to operate medical devices Supervise a remote dispensing location under the supervision of a pharmacist who is not physically present Answer the phone Updating patient profile Managing the pharmacy stock and inventory.

What Does a Hospital Pharmacist Do?

• Address reason for admission (or chief complaint)
• Review BPMH/Medication Reconciliation
• Assess medication profile, looking for any of the 7 DTPs
• Assess additional medical information (i.e. lab work, imaging, etc.)
• Make and prioritize recommendations based on acuity
• Create a follow-up plan, including monitoring
• Have more opportunities to interact closely with the prescribers and, therefore, to promote the rational prescribing and use of drugs.
• Answering the questions directed to the pharmacy department.
• Checking primary, secondary, or tertiary literature to find quick and accurate answers.
• Educating and counseling patients about medical conditions and medications.
• Dispensing medications for in-patients and out-patients.
• Reporting ADR and dispensing errors to Pharmapod and AIMS (Assurance and improvement in medication safety)

What do you know about documentation?
Documentation is defined as paperwork giving information, instructions, or references. Documentation should be organized in such a manner that all professional actions on behalf of a patient are accurately described. Examples of documentation styles include SOAP, DRP, DAP, and DDAP.

• SOAP: Subjective (findings), Objective (findings), Assessment, and Plan;
• DRP: stands for Drug-Related Problem, Rationale, and Plan;
• DAP: is Data, Assessment, and Plan;
• DDAP: refers to Drug-Related Problems, Data, Assessment, and Plan.

In your opinion, what is the most important business aspect of which a hospital pharmacist needs to be aware?
The hospital pharmacist is accountable and responsible for:

• ensuring that complex assessments of the patient are made concerning the medication(s) and the disease
• ensuring that the patient receives optimum medication therapy while minimizing the potential for adverse events all within a specified timeline.
• The pharmacist is accountable for the extensive provision of accurate information as it relates to medications for specific patients to other health care providers such as physicians and nurses.
• The pharmacist promotes the safe and appropriate use of medications in a multidisciplinary setting to minimize risk and optimize healthcare resources as they pertain to medications.
• The pharmacist participates in the education and mentoring of pharmacy students and other pharmacists.
• The pharmacist is accountable for maintaining the standards of professional practice as set out by the Ontario College of Pharmacists.

To be a competent hospital pharmacist, one should have the traits of professionalism:

• Good skills in communication,
• commitment to excellence,
• strong medical science background,
• honesty, integrity, respect for others, and compassion
• Work under stress.
• Prioritization of tasks
• Ability to work collaboratively with team members with different backgrounds and cultures.
• Up-to-date knowledge
• Strong clinical skills

What steps do you take to remain up-to-date on new medications?

Pharmacists employ several strategies to stay informed about new medications and advancements in the field. Here are some key approaches:

1. Continuing Education (CE) Programs: Pharmacists actively participate in continuing education courses. These programs provide updates on drug therapies, safety, and emerging treatments.

2. Reviewing Drug Information Updates: Pharmacists regularly review drug monographs, package inserts, and official prescribing information. They keep track of any changes, warnings, or updates related to medications.

3. Professional Organizations: Joining pharmacy organizations allows pharmacists to access resources, attend conferences, and engage in discussions with peers.

4. Pharmacy Magazines and Journals: Subscribing to pharmacy publications keeps pharmacists informed about recent research, clinical trials, and therapeutic innovations.

5. Networking: Pharmacists collaborate with colleagues, attend seminars, and participate in forums. Networking facilitates knowledge exchange and helps them stay updated on industry trends.

6. Board Certification: Becoming board-certified in specialized areas (such as oncology, critical care, or ambulatory care) demonstrates expertise and requires ongoing learning. Board-certified pharmacists stay abreast of developments in their chosen field 

What steps do you take to find the accurate answer?
It depends on what am I looking for, for example:

• If I am looking for the most up-to-date information, I usually check primary literature such as scientific journal articles that report results of case studies or clinical trials: examples: new England Journal of Medicine (NEJM)
• If I need to find primary literature I usually use secondary literature that indexes and abstracts the databases such as PubMed.
• If I need to find background information or quick answers, I use tertiary literature such as reference books, or drug monograph collections such as e-cps, or lexicomp.
• If I am looking for information related to pharmacy management, or regulations, I use the OCP website or pharmacy connection. 
  I subscribe to a variety of trade publications and newsletters.

How would you react if a physician didn’t want to change a medication you believe is not appropriate for a patient? 

If a physician declined to alter a medication that I deemed inappropriate for a patient, I would approach the situation with diplomacy and collaboration. Here are some steps I might take:

1. Open Communication: I would express my concerns to the physician, emphasizing the reasons why I believe the current medication is not suitable. Clear communication is essential to ensure patient safety.

2. Evidence-Based Discussion: I would present any relevant clinical evidence or guidelines that support my viewpoint. This could include research studies, adverse effects, or drug interactions.

3. Seek Common Ground: Rather than insisting on my perspective, I would aim to find common ground. Perhaps there are alternative medications or adjustments that both the physician and I can agree upon.

4. Consult with Colleagues: If necessary, I would seek input from other healthcare professionals, such as pharmacists or specialists. Their insights can provide a broader perspective.

5. Patient-Centered Approach: Ultimately, our focus should be on the patient’s well-being. I would advocate for what is best for the patient, considering their unique circumstances and medical history.

Remember, collaborative decision-making is crucial in healthcare, and respectful dialogue can lead to better outcomes for patients.

What is your salary expectation?
Can we share the salary expectation for this position?

Why should we hire you?
I have the required skills, experience, and qualifications for this position. I believe I am an ideal fit for this position, I have very good clinical experience from 3 different hospitals, I have very good academic backgroung about Oncology Pharmacy from the university of Toronto, I have good experience regarding sterilized and non-sterilized compounding, I am also flexible to work on weekends, night shifts and on-call, I also have a good academic background about critical appraisal of clinical trials. 

What do you think is the most difficult thing about being a clinical pharmacist?
The most difficult thing about being a clinical pharmacist is consistently meeting expectations, and doing multiple tasks at once, you have to keep everyone motivated, you need to know how to work collaboratively with the team, and keep yourself updated, it is all about communication, and problem-solving skills.

What previous work experience makes you the best candidate for this position?

What interests you about this position?
I am interested in this role which offers me opportunities for growth and development where I can continuously learn new skills that can advance me in my future career, a supportive work environment with good colleagues is also as important as a positive atmosphere. I am trying to align my skills with the hospital’s goals and values.

Describe yourself in three words
Reliable, accurate, results-oriented, ambitious, and energetic.

Tell me about a time you worked with a difficult person
There was a project where a team member and I had a conflicting approach or ideas, we set up a one-on-one meeting, discussed our concerns openly, and pinpointed areas of agreement, by actively listening and finding compromise. we not only resolved the issue but also built a stronger work relationship. This experience taught me the importance of effective communication and collaboration and overcoming workplace challenges.

What do you know about Antimicrobial stewardship?

• Antimicrobial stewardship means following guidelines to reduce the risk of creating drug-resistant organisms. It supports coordinated interventions designed to improve and measure the appropriate use of antimicrobials including selection, dosing, duration of therapy, and route of administration. Core principles of antimicrobial stewardship include timely initiation and discontinuation, appropriate selection, optimal dosing, route, and duration of antimicrobial therapy.
• The antimicrobial selection also includes consideration of local epidemiology and intrinsic antimicrobial resistance patterns and culture results, where available. Pharmacists are well-positioned to be key participants in advocating for, developing, and implementing antimicrobial stewardship strategies, regardless of whether a formal antimicrobial stewardship program has been established within the practice setting.

Tell me about a difficult clinical situation
I had come across a case referred to the pharmacy department, an 86-Y-O male, with schizophrenia and dementia, he was on:

• Methotrimeprazine 5 mg IM PRN TID, Methotrimeprazine 2.5-5mg PO PRN BID,
• Zopiclone 5mg QHS,
• Risperidone 0.5 mg PO TID PRN,
• Donepezil 5mg tablet.
• Trazodone 25mg PO PRN TID,
• Melatonin 3mg QHS
• and other non-contributory meds such as spironolactone, Coversyl, ferrous gluconate, and Lantus.

He has recently been extremely aggressive with severe agitation. Can the patient benefit from adding Carbamazepine or Divalproex 250mg BID?

Recommendations:

• Assess any environmental or medical factors that may lead to extremely aggressive behavior.
• Close monitoring of vitals, ECG (QTc prolongation), S. CPK (Neuroleptic Malig syndrome), and hydration status.
• Adding memantine to donepezil as a combo medication.
• Risperidone 1mg TID regularly, if not helpful, then
• Add quetiapine 12.5-5 mg BID, if swallowing is an issue add,
• Olanzapine zydis 2.5-5mg TID PRN. Olanzapine and quetiapine will cover both insomnia and agitation.
• Carbamazepine, no:
  • Liver microsomal enzyme inducer, 50% of olanzapine or risperidone.
  • Thrombocytopenia, hyponatremia.
• Divalproex: no
  • Thrombocytopenia in an elderly patient
  • DDI
• If not effective enough:
  • Adding beta-blocker
  • Clonidine 0.5mg tablet TID
  • Rexulti (brexpiperazole)

If you were a drug, what type of drug would you be, and why? 
“That’s a very interesting question and one I did not expect. If I were a drug, I think I’d want to be aspirin. The reason for this is that it’s one of the most basic medications that can be used to address a wide variety of symptoms and illnesses. Additionally, regular small doses of aspirin will keep the heart healthy. Since the heart is probably the most important organ and interacts with virtually every other part of the body, it is both a leader and a team player which is what I strive to be as a pharmacist.”

How do you ensure patients are properly educated about their medications?
“When it comes to patient education, I make sure it’s a priority. Whenever a patient picks up a prescription they’ve never taken before, I ask that they step aside to have a conversation. Additionally, I make sure every patient is asked if they have questions or would like to discuss their prescription.
At that point, I discuss what the medication is and its intended purpose. Next, I cover how it should be taken, including frequency and whether meals are required. Then, I review any side effects, ensuring patients are aware of what to watch out for and what may occur, but isn’t always concerning. Finally, I cover the basics of why sharing medications can be dangerous before opening up to any questions they may have. Generally, I’ve found this approach to be efficient and thorough, so it’s my go-to strategy each time.”

A pharmacist’s work life could get monotonous. What would you do to stay motivated?

• Attending medical and pharmaceutical conferences.
• Completing continuing education programs
• Presenting mini-lectures to our community about chronic medical conditions in elderly people.

Where do you see yourself in five years?
‘In five years, my goal is to be board certified oncology pharmacist. I am studying oncology pharmacy and I will build on the experience that I will gain from the hospital to achieve my ultimate goal.

What do you know about Health Canada Division 5, N2SOP, Good Clinical Practice and Tri Council Policy Statement 2 ?

• Health Canada Division 5 refers to the regulatory framework governing drugs for clinical trials involving human subjects. It provides guidance on various aspects, including authorization, consent, labelling, and safety monitoring during clinical trials in Canada. Compliance with Division 5 ensures that clinical trial sites meet regulatory standards and facilitates ethical research conduct.
• Good Clinical Practice (GCP) is an international quality standard for designing, conducting, recording, and reporting clinical trials involving human participants. It ensures patient safety, data integrity, and ethical research conduct. GCP principles are based on ICH guidelines and the Code of Federal Regulations (CFR) for clinical research trials in the U.S.
• Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS 2) provides comprehensive ethics guidance for research involving human participants. It covers topics such as consent, privacy, equity, conflicts of interest, and Indigenous research.

In summary, these frameworks and guidelines play critical roles in ensuring ethical and high-quality clinical research. They address various aspects, from regulatory compliance to participant protection and research integrity.

What do you know about NIOSH?
NIOSH, the National Institute for Occupational Safety and Health, is a CDC agency dedicated to improving workplace safety and health. Here are some key points about NIOSH

What do you know about Marvelle Koffler Breast centre?
The Marvelle Koffler Breast Centre at Mount Sinai Hospital is a premiere facility specializing in breast health and disease. It was established in 1995, thanks to the extraordinary leadership of Marvelle Koffler and Murray Koffler. Here are some key points about this remarkable center:

• Comprehensive Care: The Marvelle Koffler Breast Centre ensures that each patient receives comprehensive care, addressing both the physical and psychosocial aspects. Patients come for breast cancer screening as well as the diagnosis of benign and malignant breast conditions.

• Services Offered:

  • Screening Mammography: The center serves as an Ontario Breast Screening Program assessment site.
  • Expert Team: It houses a team of experts specializing in the diagnosis and treatment of breast conditions, including breast cancer.
  • Multidisciplinary Approach: Various health care providers collaborate under one roof, including professionals in surgery, medicine, radiological sciences, pathology, psychiatry, nursing, palliative medicine, nutrition, and social work.
  • Multidisciplinary Cancer Conference: For individuals diagnosed with breast cancer, the center’s multidisciplinary team coordinates treatment. They review medical information and provide input on the best plan of care.

• Statistics:

  • Approximately 34,000 women receive care at the Marvelle Koffler Breast Centre annually.
  • 25-30 clinicians and trainees meet weekly to review medical information on newly diagnosed breast cancer patients.
  • The center is the first dedicated breast center in Canada to integrate all aspects of breast care: detection, diagnosis, counseling, and treatment.

What are different kinds of Cancer treatment?
Certainly! There are several types of cancer treatments, each tailored to the specific type of cancer and its stage. Here are some common modalities:

1. Surgery: A procedure where a surgeon removes cancerous tissue from the body. It is often used to remove tumors or affected organs.
2. Chemotherapy: This treatment uses drugs to kill cancer cells. It can be administered orally or intravenously and is effective against rapidly dividing cells.
3. Radiation Therapy: High doses of radiation are used to kill cancer cells and shrink tumors. It is a localized treatment.
4. Immunotherapy: Enhances the body’s immune system to fight cancer cells.
5. Hormone Therapy: Slows or stops the growth of hormone-dependent cancers like breast and prostate cancer.
6. Hyperthermia: Raises body tissue temperature to damage and kill cancer cells.
7. Photodynamic Therapy: Uses light-activated drugs to target and destroy cancer cells.
8. Stem Cell Transplant: Restores stem cells destroyed by high-dose chemotherapy or radiation.
9. Targeted Drug Therapy: Focuses on specific molecules involved in cancer growth.